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Individual

DARIAN GLENN MEHALIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
2404 WISE RD, CONWAY, SC 29526-5521
(843) 365-8884
(843) 365-6685
Mailing address
2404 WISE RD, P.O. BOX 136, CONWAY, SC 29526-5521
(843) 365-8884
(843) 365-6685

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC 5054
SC
101YM0800X
Mental Health Counselor
LPC 4930
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6102804
NC
Enumeration date
09/29/2006
Last updated
01/22/2016
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